Creating a Welcoming Clinical Environment for LGBT Patients (2016)

The aim of this project was to develop a welcoming clinical environment for Lesbian, Gay, Bisexual, and Transgender (LGBT) patients at Northern Counties Health Care (NCHC) and to serve as a model for community health centers across the nation that want to provide their LGBT communities with patient centered care that is affordable, compassionate and accessible. This was achieved by revising non-discrimination policies and new patient forms to be more inclusive of sexual orientations and gender identities, incorporating LGBT health learning modules into yearly provider and staff mandatories, and adding LGBT inclusive material into all waiting and exam rooms.

The effectiveness of these interventions was evaluated using the Healthcare Equality Index (HEI) scoring criteria developed by the Human Rights Campaign. Future interventions include registering competent and sensitivity trained providers to the GLMA (Health Professionals Advancing LGBT Equality) provider directory, including data fields for sexual orientation and gender identity as part of the electronic health record (EHR) for all patients, conducting a community needs assessment with local LGBT groups such as Outright Vermont and NEK LGBTQ Advocacy Committee, developing a partnership with the DHMC Transgender Clinic for additional training in the management of hormone therapies, and measuring LGBT patient satisfaction through phone interviews.

Ramadan, Samy S., “Creating a Welcoming Clinical Environment for LGBT Patients” (2016). Family Medicine Clerkship Student Projects. Book 163.

Living with Hepatitis C: A Vermont Needs Assessment (2015)

Introduction: Estimates show 1.63 cases of hepatitis C (HCV) per 1000 people in Vermont. Many are aware of their status, but do not seek treatment because of the demands of poverty and ineligibility due to IV drug use. Literature recommends modeling HCV care on the multi-disciplinary approach used for HIV/AIDS treatment. Vermont CARES (VT CARES), an HIV/AIDS service organization, is seeking to expand its services to Vermonters living with HCV.

Objectives: To investigate the usefulness and appeal of VT CARES’ services to patients living with HCV. To learn more about the demographics of Vermonters living with HCV. To determine whether these patients are comfortable accessing services through VT CARES.

Methods: HCV patients were surveyed at seven sites throughout Vermont. The survey consisted of 20 questions to assess demographics and the applicability of existing services at VT CARES.  Raw data (n=48) were compiled, then analyzed graphically and with non-parametric statistical methods.

Results: 58% of respondents acquired their HCV infection via IV drug use.  77% rated at least one service by VT CARES to be “very helpful” in getting or staying on track with their HCV treatment. 72% reported feeling “somewhat comfortable” or “very comfortable” receiving services from VT CARES. Few were pursuing HCV treatment, but case management was associated with greater likelihood of pursuing it.

Recommendations: VT CARES should expand their services to include clients with HCV. Funding for viral hepatitis at the state and federal level should be expanded. Future research should look into barriers to HCV treatment.

Brown, Alexandra; Genziano, Justin; Powers, Julia; Ramadan, Samy; Schumer, Amy; Shear, Matthew; Wang, Katherine; Jacobsen, Peter; and Larrabee, Jerry, “Living with Hepatitis C: A Vermont Needs Assessment” (2015). Public Health Projects, 2008-present. Book 220.

Presented at the 2016 APHA Annual Meeting & Expo, Denver, CO, November 2, 2015.

Presented at the 2015 UVM Annual PHP Poster Session, Burlington, VT, January, 2015.

In the news…

Class of ’17 Public Health Project Helps VT CARES Earn Grant

Helping Patients with Hepatitis C Through the Public Health Projects

Public Health Project Helps Vermont CARES Gain Funding